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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A study was made, at the altitude of Mexico City, of the clinic aspects and of the pulmonary function of 26 obese subjects more than 45% overweight. This excess weight habitually produces severe disturbances in pulmonary and/or heart function. In 50% of the patients, clinic, radiologic and electrocardiographic manifestations were found which suggested the existence of pulmonary arterial hypertension. This provoked right heart failure in 19% of the cases. The most constant alterations in the pulmonary volumes was the decrease in the VER, which occurred in 96% of the cases. Most of the patients had hypoxemia (92.5), which was produced mainly by the increase in venoarterial shunts. Although the clinic manifestations were similar to those described in Pickwick's syndrome, alveolar hypoventilation was presented in only a minority of the cases. No relationship was found between the degree of obesity and alveolar hypoventilation. Altitudes of 2,200 meters or more apparently favor hypoxemia in obese patients, and "protects" them from the hypercapnea. The altitude of Mexico City may be one of the reasons why alveolar hypoventilation is observed in only 15% of the cases.
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PMID:[Respiratory changes in obesity. Functional and clinical aspects. Study of 26 cases]. 113 Sep 8

A 26-year-old woman who had been taking an oral contraceptive preparation for two years developed malignant hypertension. Investigation failed to elicit any renal or other cause for her hypertension, but control of blood pressure was obtained by withdrawal of the oral contraceptive agent and antihypertensive therapy. Subsequently, after withdrawal of therapy, the blood pressure remained near normal. The patient had a previous history of hypertension during pregnancy; she was also overweight.
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PMID:Malignant hypertension associated with use of oral contraceptives. 113 38

In a case-control-study an epidemiological investigation of cancer of the endometrium was carried out. 407 patients with cancer of the endometrium were compared with a control group of 450 women. The patients with endometrial cancer differed from the control group in the following manner: Significantly higher incidence of diabetes mellitus and hypertension. Overweight could not be printed out reliably, but there are so many corresponding statements in literature about a higher degree of overweight that there could be no doubt about it. Furthermore the patients with carcinoma of the uterine corpus had an earlier menarche, a later menopause, a smaller number of deliveries and more menstrual abnormalities. They were more exposed to radiation in the pelvis, the incidence of malignant tumors was higher in their families. So factors of high risk related to cancer of the endometrium could be defined.
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PMID:[Epidemiological aspects of corpus carcinoma]. 118 76

One hundred pregnant patients weighing 80 kg or over at the 14th week of pregnancy were studied during their antenatal period and delivery. The incidence of pre-eclampsia, hypertension, pyelitis of pregnancy and operative delivery was higher in overweight patients than in an equivalent number of patients of average weight also studied. The age-related difference in antenatal weight gain in obese patients was confirmed. Two maternal deaths occurred among the overweight patients.
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PMID:Pregnancy in the overweight Nigerian. 119 6

A careful codification according to the rules of electronic data processing of all data given and especially of the admission number on the signature margin of th medical record gives the possiblity of a rapid return of information for the practice and of a scientific evalustion. 404 patients with hypertension (400-404) of the distric Rostock who were treated in the clinic simultaneously suffered from gastrointestinal diseases (531-536, 570-577). For a more specialized analysis of the clinical data from case histories the four largest institutions of the district were chosen. From this results a relation number of 100 patients with these diagnostic combinations. 73% of these patients were of female sex. The higher blood pressure values at the beginning of the treatment we find in hypertensive patients with simultaneous disease of the gallbladder, in which cases these patients to 44% also showed an overweight. In 74% of the patients there occurred a systolic decrease of blood pressure, in 66% a diastolic one. More frequently than on the average the decrease of the blood pressure appeared in patients with liver and gall-bladder diseases.
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PMID:[Hospitalized hypertensiol patients with gastrointestinal disease]. 119 42

In a health examination survey of more than 2,000 middle-aged men the prevalence of hypertension, defined as supine DBP greater than or equal to 105 mmHg and including those on treatment, was 7.5%. Half of the hypertensives were untreated. A satisfactory BP control was present in 27.6% of the total hypertensive population. Untreated hypertensives had a higher relative body weight and a greater skinfold thickness, indicating a greater degree of obesity, than a population sample from the same survey. They also had more hyperuricaemia, hypertriglyceridaemia and hyperinsulinaemia, fasting as well as during i.v. glucose tolerance test. However, when the hypertensives were compared to normotensive, weight-matched controls, most of these differences were eliminated. The findings indicate that the metabolic disturbances in hypertensives are associated with overweight and suggest that weight reduction might be beneficial not only for the BP but also for correcting the metabolic pattern.
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PMID:Detection and characterization of middle-aged men with hypertension. 126 64

It has been proposed that hyperinsulinemia may not constitute a cardiovascular risk in women, and that the metabolic risk profile is less apparent in women than in men. In two different studies, we have assessed the interrelationship between classical coronary risk factors in women with untreated essential hypertension and looked for possible hypertensive-normotensive differences. Hypertensive women (HT1, 156 +/- 2/98 +/- 1 mm Hg, n = 18) in study I turned out to be overweight and had nearly three times higher fasting serum insulin levels than the normotensive control subjects (NT1, 118 +/- 3/77 +/- 2 mm Hg, n = 9). HT1 women with a body mass index (BMI) above 25 kg/m2 had significant higher insulin levels than HT1 women with a BMI less than 25 kg/m2, and when adjusting for BMI the hypertensive-normotensive difference in insulin levels was lost. In HT1 women, the serum insulin level correlated positively to the BMI and triglycerides. In study II, insulin was positively associated with the systolic blood pressure in HTII women (150 +/- 3/99 +/- 1 mm Hg, n = 29), and a negative correlation appeared between the glucose/insulin ratio and the systolic as well as diastolic blood pressure. No difference was observed in BMI and insulin between HTII and NTII women (121 +/- 3/79 +/- 1 mm Hg, n = 18). In HTII women, plasminogen activator inhibitor (PAI-1) levels were higher and the euglobulin clot lysis time prolonged compared to NTII women. PAI-1 was positively correlated to insulin and triglycerides and negatively to high-density lipoprotein (HDL) cholesterol in HTII women. Strong associations between potential cardiovascular risk factors seem to be present even in untreated women with mild hypertension, with insulin being correlated to hypertension, BMI, fibrinolytic activity, triglycerides, and HDL cholesterol.
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PMID:Hypertension and the metabolic cardiovascular syndrome: special reference to premenopausal women. 128 64

Diabetes mellitus is commonly associated with systolic and diastolic hypertension, and a wealth of epidemiological data suggest that this association is independent of age and obesity. Much evidence indicates that the link between diabetes and essential hypertension is hyperinsulinemia. Thus, when hypertensive patients, whether obese or of normal body weight, are compared with age- and weight-matched normotensive controls, a heightened plasma insulin response to a glucose challenge is found consistently. A state of cellular resistance to insulin action subtends the observed hyperinsulinism. Using the insulin/glucose clamp technique in combination with tracer glucose infusion and indirect calorimetry, it has been demonstrated that the insulin resistance of essential hypertension is located in peripheral tissues (muscle), is limited to nonoxidative pathways of glucose disposal (glycogen synthesis), and correlates directly with the severity of hypertension. The reasons for the association of insulin resistance and essential hypertension can be sought in at least four general types of mechanisms: sodium retention, sympathetic nervous system overactivity, disturbed membrane ion transport, and proliferation of vascular smooth-muscle cells. Physiological maneuvers, such as caloric restriction (in the overweight patient) and regular physical exercise, can improve tissue sensitivity to insulin; good evidence indicates that these maneuvers also can lower blood pressure in both normotensive and hypertensive individuals. Insulin resistance and hyperinsulinemia also are associated with an atherogenic plasma lipid profile. Elevated plasma insulin concentrations enhance very-low-density lipoprotein (VLDL) synthesis, leading to hypertriglyceridemia. Progressive elimination of lipid and apolipoproteins from the VLDL particle leads to an increased formation of intermediate density and low-density lipoproteins, both of which are atherogenic. Last, insulin per se, independent of its effects on blood pressure and plasma lipids, is known to be atherogenic. The hormone enhances cholesterol transport into arteriolar smooth-muscle cells and increases endogenous lipid synthesis by these cells. Insulin also stimulates the proliferation of arteriolar smooth-muscle cells, augments collagen synthesis in the vascular wall, increases the formation of and decreases the regression of lipid plaques, and stimulates the production of a variety of growth factors. In summary, insulin resistance appears to be a syndrome that is associated with a clustering of metabolic disorders, including type II diabetes mellitus, obesity, hypertension, lipid abnormalities, and atherosclerotic cardiovascular disease.
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PMID:Insulin resistance, hyperinsulinemia, and coronary artery disease: a complex metabolic web. 128 37

Benign intracranial hypertension (BICH) is a rare adverse event. We report the case of a 31-year-old female drug addict who had been seropositive for HIV since 1987. She had stage IV C1 AIDS, and was receiving intravenous amphotericin B for generalized cryptococcosis with no neuromeningeal involvement. She developed BICH that regressed when the antifungal drug was withdrawn and treatment for cerebral edema was started. BICH is a clinical entity involving intracranial hypertension with no focal neurological signs or detectable intracranial lesion. The manifestations include headache, transitory or permanent visual disturbances (diplopia, loss of visual acuity) and the perception of intracranial noise. The cerebrospinal fluid is under increased pressure but the composition is normal. The eye fundus examination shows papillary edema, and the neuroradiological workup is normal. BICH can only be diagnosed once an expansive intracranial process, neuromeningeal infection, and non-communicative hydrocephalus have been ruled out. In the majority of cases, no etiology is found. Such cases of idiopathic BICH usually occur in overweight young women, although drugs can be implicated. Amphotericin B has not previously been held responsible for BICH. On the basis of this observation, we present a review of the literature.
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PMID:[Drug-induced benign intracranial hypertension. Apropos of a case with amphotericin B. Review of the literature]. 129 80

In the years 1986-1987, the blood viscosity factor, the content of haemoglobin in erythrocytes, the concentration of glucose in blood, the lipids and the blood coagulation system were examined in 180 subjects. They were divided into three groups according to the exposure to risk factors: group performing light manual work (L), group performing hard manual work (C) and group of engine drivers (M). No statistically significant differences in regard to age, employment period, number of cigarettes smoked, as well as arterial systolic and diastolic blood pressure were found between the subjects. Workers from group M had the highest body weight (P > 99%) and increased concentration in blood of triglycerides (P > 99% and Apo B (P > 99%. Subjects from group C had the lowest concentration of cholesterol in blood (P > 99%) and the smallest number of members with hypertensions (3.8%) and overweight (7.5%). Group L included the highest percentage of persons with arterial hypertension (17.5%), the highest, among all examined, blood viscosity factor determined at the coagulation rate of 18.6 s-1, and the lowest prothrombin factor (P > 99%).
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PMID:[Blood viscosity factor in persons with high and low risk of ischemic heart disease]. 130 May 73


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